GP Crisis is being ignored despite the many reports

@wesstreeting even commissioned the Darzi Report but is ignoring it’s advice on GPs

@CareQualityComm State of Care
@CommonsHealth The Future of General Practice
@instituteforgov General practice across England
@pulsetoday Darzi Report 2024
assets.publishing.service.gov.uk/media/66f42ae6…

Primary Care Training Hubs

Promoting the training & development of additional roles in General Practice, except GPs & Practice Nurses

So no prioritisation for tackling GP /GPN unemployment & underemployment? Where is the accountability? @wesstreeting

hee.nhs.uk/our-work/prima… Whilst the Multi-disciplinary Team is vital to good community care, so is planning, joining up thinking & accountability

There has been a huge rise in additional roles without real understanding of the need for GPs & GPNs in practices

This is failure @NHSE_WTE & @NHSEngland

It’s increasingly hard to see a Doctor

Policies made by NHS leaders & Governments have lead to fewer GPs

Many GPs finishing training next month will not have jobs to start, with many unemployed or working less than they would chose

All due to policies & lack of funding for GPs The biggest change over the past 5 years has been NHS England led imposition of ARRS (Additional Roles)

Aimed at increasing access to a wider workforce in primary care

Until last year this excluded GPs & practice nurses resulting in fewer roles

But a massive expansion of ARRS

Blackpool

Known for the Tower, the winter lights , summer holidays & Strictly Come Dancing. But behind the glamour is one of the poorest most deprived areas of the country

The life expectancy is more than 10yrs lower than the UK average & health inequalities are a huge problem As recently as October 2024, the local health leaders Kevin Lavery & Dr Andy Knox were sat in front of NHS England’s board sharing insight, successes & challenges. They were applauded for the work with Chair Richard Meddings full of praise.

1hr 14mins

The UK is a relatively low tax economy

This means the revenue raised by Government as a proportion of GDP has been low historically

Less funding raised for infrastructure/healthcare/education etc

A thread 🧵 Infrastructure spending is some of the worst

This results in poorer roads, hospitals, less beds etc

GP TRAINING an example for @gmcuk @wesstreeting @DHSCgovuk @NHSE_WTE

GPs are trained extensively Minimum:
5 years of medical school
2 foundation years which include surgery and medicine
Plus 3 years minimum as experienced Doctors with extensive supervision, exams & assessments GPs understand the full curriculum of education as set out by RCGP

This is a full and comprehensive curriculum covering all aspect of medical education and health & social care rcgp.org.uk/mrcgp-exams/gp…

1500 more GPs added to the workforce or have they?
@wesstreeting
The headline this week was 1500 more GPs have been added to the workforce since the change in the rules around recruitment of GPs in the Additional Roles Reimbursement Scheme (ARRS) allowed GPs to be recruited. But behind the headlines there isn’t as much to be happy about. I am continuing to hear of GPs unable to get work, or work the number of sessions that they would like . GP unemployment and underemployment hasn’t gone away, despite patients needing GPs.

GP Core funding is just £107.57/patient/year
@BMA_GP
@DAUK_GP has until now been using the average total figure £165 which includes premises payments, prescribing income & payments for QOF, which are not part of the core contract
Either way it’s not enough
digital.nhs.uk/data-and-infor…
There are huge variations in the income receive per practice with even the average £165 hiding differences in dispensing practices vs non-dispensing

So focusing on £107.57 core GP funding reflects more closely what practices get to employ the staff to provide care for patients

Richard Meddings - Chair of NHS England ‘Doctors are over-qualified’
Asked if it should be possible to train a doctor in less than 7 years
‘I would have thought so. Or you go to physician associates – so you change the skill levels’

NHS England Board has Post Office Board ‘vibe’ dailymail.co.uk/health/article…

NHS vs Private providers

With less than 15% of NHS work done by Private providers, the ‘easy’ stuff, they aren’t going to be the solution to backlogs

Govt/Labour have continued to listen to their leaders

There are solutions which require listening to those who understand Just 24,000 a month self pay compared to 1.4million using the NHS Hospitals

https://twitter.com/drstevetaylor/status/1777734356280467459

Whopping Whippet stories from the Tories and Victoria Atkins

A thread of mistruths Nurses 🤔

https://twitter.com/drstevetaylor/status/1782021584128975156

GP Partnerships - Time for a salaried service?
I keep hearing politicians say that GPs don’t want to be Partners & want to to be Salaried

Well that’s a self fulfilling prophecy since they are the ones deciding funding
Remove the funding for a business & who would want to do it So wants behind this assumption

Firstly there has been a fall in GP Partners & rise in Salaried GPs
The headcount numbers look overwhelming

GP Practices are closing, financially unviable, younger GPs leaving
some unemployed
Yet @NHSEngland @VictoriaAtkins @andrealeadsom are failing to fund GP Practices with a cut of 2% this year
20% £/patient real terms cut in funding since 2016
This is not News it needs repeating

https://twitter.com/skynews/status/1662011295250382848

Is General Practice FOR SALE?
Private firms ‘lobby’ Lords & MPs as Govt courts the private sector in the future of the NHS
Lords Farmer & Bethell, Centene, Virgin Care, Operose, HCRG, Twenty20
Operating a model of Primary Care aimed at profitability
bylinetimes.com/2021/10/25/lor… Panorama gathered evidence that PAs were not being properly supervised at the Operose practice. The PAs told the undercover reporter they saw all sorts of patients, sometimes without any clinical supervision. The practice treated them as equivalent to GPs

bbc.co.uk/news/health-61…

GP Partners to blame for missed Cancer Diagnosis

In the case below the poster was asking whether to complain.
I feel for all involved
The patient who was delayed
The PA who will be upset at missing this
The receptionist who was doing what they were told
The GP who was worried
🧵 The GP Partner is to blame here because ultimately they are held responsible
They make the decisions for how the practice is run.
Employed the PA, put the PA on the Doctors rota, allowed the PA to see undifferentiated patients. Told the receptionist how explain to patients
2/

GPs - Facts or fiction 🧵
They are not seeing patients F2F
Why are waiting rooms are empty
They are not working
AEs are full because GPs aren’t seeing patients
They shut their doors during the pandemic
They are all part-time
They are paid too much
They no longer care
1/9 GPs are not seeing patients Face to Face
1.4million people a day have an appt with GP practices which is up 200000 appts/day from 2019
More Face to Face, tele, e-consults, home visits, on the day
There are also less GPs - 2000 fewer than 2015 when the Govt promised 5000 more
2/9

Rishi Sunak has been keen to blame striking Doctors for increasing waiting times & cancelled operations, despite the fact he is reportedly personally blocking any pay resolution
But let’s look at the evidence
Fewer operations were cancelled in 2023 ccd 2022 with more admissions🧵 In addition to fewer operations being cancelled there have been an increase in completion of Referral to treatment pathways compared to previous years, so no decrease in performance of hospitals due to strikes
🧵/2

NHS England, Department of Health, Amanda Pritchard, Victoria Atkins all stating that they have hit the target for 5000 extra beds promised in January 23
Dishonesty at the highest levels
If hospitals are unable to function it’s not the staff to blame, it’s the failure of leaders The promise was made in January 2023 which was not a peak in bed numbers but indicative of Winter pressures at the time

The number of patients per GP in UK has increased 15% since 2016
GPs continue to be in short supply 8% fewer with a 7% increase in population
The good news for the people of UK is there is a website👇🏻to show you what’s happening locally

Speak to your MP
commonslibrary.parliament.uk/constituency-d…
North Yorkshire @RishiSunak

https://twitter.com/drstevetaylor/status/1738157928865992966

THE UK CAN’T AFFORD TO BE SICK

The cost of sickness in the economy is estimated at £150bn in lost activity, tax take, on going cost to NHS & care

Rise in long-term sick costing a lot more than that needed in investment in the NHS/Health

UK can’t afford NOT to invest in the NHS Research conducted est that the total economic cost of lost output among working-age people due to ill health is around £150bn/yr, equivalent to 7% of GDP, with an additional total cost to the Govt (lost tax income, benefits, costs to the NHS) of £70bn
oxera.com/wp-content/upl…

A THREAD FOR LABOUR

‘Labour’s plans would see GPs paid more for respecting the wishes of their patients, with funding redistributed to favour practices with a strong record on continuity of care and respecting patient preferences’

@wesstreeting @DrRosena @Keir_Starmer

https://twitter.com/wesstreeting/status/1696067846692913217

Continuity is key for good patient care and GPs agree

The problem is with the average GP caring for 2300 patients this is really challenging- imagine caring for 3000

Often this is in the more deprived areas so funding for continuity will favour less deprived areas & practices